ABSTRACT
BACKGROUND AND PURPOSE: Several small retrospective studies have observed that patients with a purely ocular manifestation of myasthenia gravis (MG) are significantly less likely to convert to a generalized disease when treated early on with corticosteroids. However, given the limited number of reported patients in the literature these findings still remain controversial. METHODS: In order to increase the number of published cases, we performed a retrospective analysis on 44 patients with newly diagnosed ocular MG who were subsequently either treated with corticosteroids or received no immunosuppressive therapy at all. The generalization rate was assessed at the end of a 2-year follow-up period. RESULTS: Whereas none of 17 treated patients generalized, 11 of 27 (41%) untreated patients developed generalized symptoms. The difference between the groups was significant (P=0.003). CONCLUSIONS: Our results agree well with previous studies on this issue. Taken together, published data indicate risk ratios for generalization of below 0.32 under corticosteroid treatment in comparison to untreated patients.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Eye Diseases/drug therapy , Immunosuppressive Agents/therapeutic use , Myasthenia Gravis/drug therapy , Prednisolone/therapeutic use , Adult , Age of Onset , Aged , Autoantibodies/blood , Blepharoptosis/etiology , Blepharoptosis/physiopathology , Cholinesterase Inhibitors/therapeutic use , Disease Progression , Eye Diseases/physiopathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Muscle Weakness/etiology , Muscle Weakness/physiopathology , Myasthenia Gravis/physiopathology , Oculomotor Muscles/physiopathology , Pyridostigmine Bromide/therapeutic use , Receptors, Cholinergic/immunology , Retrospective Studies , Risk AssessmentABSTRACT
BACKGROUND: Peritumoral brain edema in glioblastoma patients is a frequently encountered phenomenon that strongly contributes to neurological signs and symptoms. The role of peritumoral edema as a prognostic factor is controversial. MATERIALS AND METHODS: This multi-centre clinical retrospective study included 110 patients with histologically proven glioblastoma. The prognostic impact on overall survival of pre-treatment peritumoral edema detected on MRI-scans was evaluated. All patients had preoperative MRI, surgery, histology, and received standard treatment regimens. Edema on MRI-scans was classified as minor (<1 cm), and major (>1 cm). RESULTS: Our results confirm that peritumoral edema on preoperative MRI is an independent prognostic factor in addition to postoperative Karnofsky performance score (KPS), age, and type of tumor resection. Patients with major edema had significant shorter overall survival compared to patients with minor edema. CONCLUSION: This easily applicable early radiological characterization may contribute to a more subgroup oriented treatment in glioblastoma patients for future trials, as well as in clinical routine.
